Systems and methods for matching, naming, and displaying medical images

ABSTRACT

A method of matching medical images according to user-defined matches rules. In one embodiment, the matched medical images are displayed according user-defined display rules such that the matched medical images may be visually compared in manner that is suitable to the viewer&#39;s viewing preferences.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation of U.S. application Ser. No.12/870,645, filed Aug. 27, 2010, entitled “SYSTEMS AND METHODS FORMATCHING, NAMING, AND DISPLAYING MEDICAL IMAGES,” now U.S. Pat. No.8,094,901, which is a continuation of U.S. application Ser. No.11/265,978, filed Nov. 3, 2005, entitled “SYSTEMS AND METHODS FORMATCHING, NAMING, AND DISPLAYING MEDICAL IMAGES,” now U.S. Pat. No.7,787,672, which claims priority under 35 U.S.C. §119(e) to U.S.Provisional Application Ser. No. 60/625,690, filed on Nov. 4, 2004, eachof which are hereby expressly incorporated by reference in theirentirety.

BACKGROUND OF THE INVENTION

1. Field of the Invention

This invention relates to matching, naming, and displaying medicalimages based upon user-defined rules.

2. Description of the Related Art

Medical imaging is increasingly moving into the digital realm. Thisincludes imaging techniques that were traditionally analog, such asmammography, x-ray imaging, angiography, endoscopy, and pathology, whereinformation can now be acquired directly using digital sensors, or bydigitizing information that was acquired in analog form. In addition,many imaging modalities are inherently digital, such as MRI, CT, nuclearmedicine, and ultrasound. Increasingly these digital images are viewed,manipulated, and interpreted using computers and related computerequipment. When medical images are created, they are typically providedan identifier, label, or name. This name can be either automaticallygenerated or provided by a technician. One problem with organizingmedical images from different sources is that these identifiers do notnecessarily provide a good description that is understandable to asubsequent viewer of the image. Furthermore, as the number of imagesincrease, there is a need for improved methods of matching relatedmedical images together for subsequent viewing and analysis.

SUMMARY OF THE INVENTION

One embodiment comprises a method of displaying medical data. The methodcomprises receiving a plurality of medical images of a first medicalexamination and receiving at least one user-defined matching rules, atleast one of user-defined matching rules identifying selection criteriafor the medical images. The method also comprises selecting medicalimages that satisfy the selection criteria of the user-defined rules,thereby matching medical images according to user-specific rules andreceiving at least one user-defined display rule, at least one ofuser-defined display rules identifying a display preference with respectto selected medical images. The method also comprises displaying theselected medical images according to the identified display preferences,thereby allowing matched medical images to be visually compared anddisplayed in a manner that is suitable to the user's preferences.

Another embodiment comprises a method displaying medical data. Themethod comprises receiving a plurality of medical images of a firstmedical examination and receiving a plurality of medical images of asecond medical examination. The method also comprises receiving at leastone user-defined matching rule, at least one of user-defined matchingrules identifying selection criteria for matching the medical images ofthe first and second medical examinations. The method also comprisesselecting medical images that satisfy the selection criteria of theuser-defined rules, thereby matching medical images of the first medicalexamination with medical images of the second examination according touser-specific rules. The method also comprises receiving a plurality ofuser-defined display rules, at least one of user-defined display rulesidentifying a display preference with respect to selected medicalimages. The method also comprises displaying the selected medical imagesaccording to the identified display preferences, thereby allowingmatched medical images to be visually compared and displayed in a mannerthat is suitable to the user's preferences.

Another embodiment comprises a system for displaying medical data. Thesystem comprises an electronic device being configured to receive aplurality of medical images of a first medical examination. Theelectronic device is configured to receive a plurality of user-definedmatching rules. At least one of user-defined matching rules identifyselection criteria for the medical images. The electronic device isfurther configured to select medical images that satisfy the selectioncriteria of the user-defined rules, thereby matching medical imagesaccording to user-specific rules. The electronic device is furtherconfigured to receive a at least one user-defined display rules. Atleast one of user-defined display rules identify a display preferencewith respect to selected medical images. The electronic device isfurther being configured to display the selected medical imagesaccording to the identified display preferences, thereby allowingmatched medical images to be visually compared and displayed in a mannerthat is suitable to the user's preferences.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a block diagram of an exemplary computing system incommunication with a network and various networked devices.

FIG. 2 is a flowchart illustrating an exemplary process of matching anddisplaying medical images.

DETAILED DESCRIPTION OF EMBODIMENTS OF THE INVENTION

Embodiments of the invention will now be described with reference to theaccompanying figures, wherein like numerals refer to like elementsthroughout. The terminology used in the description presented herein isnot intended to be interpreted in any limited or restrictive manner,simply because it is being utilized in conjunction with a detaileddescription of certain specific embodiments of the invention.Furthermore, embodiments of the invention may include several novelfeatures, no single one of which is solely responsible for its desirableattributes or which is essential to practicing the inventions hereindescribed.

FIG. 1 is a block diagram of an exemplary computing system 100 incommunication with a network 160 and various network devices. Thecomputing system 100 may be used to implement certain systems andmethods described herein. The functionality provided for in thecomponents and modules of computing system 100 may be combined intofewer components and modules or further separated into additionalcomponents and modules.

The computing system 100 includes, for example, a personal computer thatis IBM, Macintosh, or Linux/Unix compatible. In one embodiment, theexemplary computing system 100 includes a central processing unit(“CPU”) 105, which may include a conventional microprocessor, anapplication module 145 that comprises one or more various applicationsthat may be executed by the CPU 105. The application module 145 mayinclude, by way of example, components, such as software components,object-oriented software components, class components and taskcomponents, processes, functions, attributes, procedures, subroutines,segments of program code, drivers, firmware, microcode, circuitry, data,databases, data structures, tables, arrays, and variables.

The computing system 100 further includes a memory 130, such as randomaccess memory (“RAM”) for temporary storage of information and a readonly memory (“ROM”) for permanent storage of information, and a massstorage device 120, such as a hard drive, diskette, or optical mediastorage device. Typically, the modules of the computing system 100 areconnected to the computer using a standards-based bus system. Indifferent embodiments of the present invention, the standards based bussystem could be Peripheral Component Interconnect (PCI), Microchannel,SCSI, Industrial Standard Architecture (ISA) and Extended ISA (EISA)architectures, for example.

The computing system 100 is generally controlled and coordinated byoperating system software, such as the Windows 95, 98, NT, 2000, XP orother compatible operating systems. In Macintosh systems, the operatingsystem may be any available operating system, such as MAC OS X. In otherembodiments, the computing system 100 may be controlled by a proprietaryoperating system. Conventional operating systems control and schedulecomputer processes for execution, perform memory management, providefile system, networking, and I/O services, and provide a user interface,such as a graphical user interface (“GUI”), among other things.

The exemplary computing system 100 includes one or more of commonlyavailable input/output (I/O) devices and interfaces 110, such as akeyboard, mouse, touchpad, and printer. In one embodiment, the I/Odevices and interfaces 110 include one or more display devices, such asa monitor, that allows the visual presentation of data to a user. Moreparticularly, display devices provide for the presentation of GUIs,application software data, and multimedia presentations, for example. Inone embodiment, a GUI includes one or more display panes in whichmedical images may be displayed. According to the systems and methodsdescribed below, medical images may be stored on the computing system100 or another device that is local or remote, displayed on a displaydevice, and manipulated by the application module 145. The computingsystem 100 may also include one or more multimedia devices 140, such asspeakers, video cards, graphics accelerators, and microphones, forexample.

In the embodiment of FIG. 1, the I/O devices and interfaces 110 providea communication interface to various external devices. In the embodimentof FIG. 1, the computing system 100 is coupled to a network 160, such asa LAN, WAN, or the Internet, for example, via a communication link 115.The network 160 may be coupled to various computing devices and/or otherelectronic devices. In the exemplary embodiment of FIG. 1, the network160 is coupled to imaging devices 170, an image server 180, and amedical facility 190. In addition to the devices that are illustrated inFIG. 1, the network 160 may communicate with other computing, imaging,and storage devices.

The imaging devices 170 may be any type of device that is capable ofacquiring medical images, such as an MRI, x-ray, mammography, or CT scansystems. The image server 180 includes a data store 182 that isconfigured to store images and data associated with images. In oneembodiment, the imaging devices 170 communicate with the image server180 via the network 160 and image information is transmitted to theimage server 180 and stored in the data store 182. In one embodiment,the image data is stored in Digital Imaging and Communications inMedicine (“DICOM”) format. The complete DICOM specifications may befound on the National Electrical Manufactures Association Website at<medical.nema.org>. Also, NEMA PS 3—Digital Imaging and Communicationsin Medicine, 2004 ed., Global Engineering Documents, Englewood Colo.,2004, provides an overview of the DICOM standard. Each of theabove-cited references is hereby incorporated by reference in theirentireties. In one embodiment, the data store 182 also stores theuser-defined display rules associated with one or more of the imagesstored on the data store 182. As discussed in further detail below, theuser-defined display rules may vary depending of the type of image, areaimaged, clinical indication, source of image, display device, user, orother factors. Accordingly, any type of user-defined display rule isexpressly contemplated for use in conjunction with the systems andmethods described herein.

The exemplary image server 160 is configured to store images frommultiple sources and in multiple formats. For example, the image server160 may be configured to receive medical images in the DICOM format frommultiple sources, store these images in the data store 182, andselectively transmit medical images to requesting computing devices.

The medical facility 190 may be a hospital, clinic, doctor's office, orany other medical facility. The medical facility 190 may include one ormore imaging devices and may share medical images with the image server180 or other authorized computing devices. In one embodiment, multiplecomputing systems, such as the computing system 100 may be housed at amedical facility, such as medical facility 190.

Definition of Terms

Below is a definition of certain terms used herein.

“Modality” is defined as a medical imaging device (a patient whoundergoes an MRI is said to have been examined or scanned with the MRImodality).

“Medical image” is defined to include an image of an organism. It mayinclude but is not limited to a radiograph, computed tomography (CT),magnetic resonance imaging (MRI), Ultrasound (US), mammogram, positronemission tomography scan (PET), nuclear scan (NM), pathology, endoscopy,ophthalmology, or many other types of medical images. While thisdescription is directed to viewing and tracking of medical images, themethods and systems described herein may also be used in conjunctionwith non-medical images, such as, images of circuit boards, airplanewings, and satellite images, for example.

“Patient” refers to an individual who undergoes a medical imagingexamination.

“Viewing” is defined to include the process of visually observing one ormore medical images associated with exams.

“Viewer” is defined as any person who views a medical image.

“Reading” is defined to include the process of visually observing one ormore medical images for the purpose of creating a professional medicalreport, also called an interpretation. When reading is complete, an exammay be labeled “read,” indicating that the medical professional hascompleted observation of the one or more medical images for purposes ofcreating a medical report.

“Reader” is defined to include one who is authorized to perform thereading process.

“User” is defined to include any person that is a viewer and/or areader.

“Display rules” are defined to include methods of display of an image orexam. For example, an image or exam may be displayed with a certainpixel window level or width (similar to brightness and contrast), incolor, based on a certain color map, opacity map, or other displayparameters.

“User-defined display rules” refers to rules that a user can establishand store in a database that establish criteria for image display thatis considered adequate. For example, a user-defined display rule mightstore a rule that triggers certain warnings or displays if all pixels ina medical image have not been displayed or, alternatively, if at least apredetermined portion of the pixels have not been displayed with acertain display method (such as image window, level, brightness,contrast, opacity, color look-up table, or other parameters).User-defined display rules may also refer to other image processingfunctions, such as edge enhancement and automated image analysisfunctions, e.g., computer-aided detection (CAD) techniques.

FIG. 2 is a high-level flowchart describing an exemplary method that maybe performed by the computing system 100 (FIG. 1). Depending on theembodiment, additional steps may be added, others removed, and theordering of the steps rearranged.

Starting at step 200, matching rules are provided with respect tomedical images that are accessible by the computer system 100. Themedical can be accessible via the imaging server 180, be local to thecomputing system 100, or elsewhere accessible via the network 160. Thematching rules establish criteria for matching related medical images.In one embodiment, the matching rules are defined for a particularindividual or machine. In another embodiment, the matching rules aredefined for a group or class of individuals. The rules may be providedby the users themselves and/or by a system administrator. Theauto-matching rules may be established to select medical data based uponany of the following non-limiting criteria: modality (MRI, CT, X-rayetc); exam type (left knee X-ray, CT Chest, MRI Brain etc); archivestatus (has the exam been archived, archived and restored, not yetarchived); assigned physician (has the exam been assigned to aparticular physician for interpretation); exam age (how long ago was theexam done); patient age; and any item in a DICOM header file, such asorientation, contrast use, thickness of slices, field of view, MRItissue contrast weighting, and other items. With regard to somecriteria, such as MRI tissue contrast weighting, the rules may analyzethe MRI pulse sequence and the imaging parameters in order to determinethe tissue contrast weighting and subcategorize images into weightingcategories or weighting names.

The matching rules can be used to match medical images in the sameand/or different medical series. For example, assume the medical imagesrelate to three series of 6 x-rays. The matching rules can beestablished such that like views amongst each of the different seriesare grouped together for subsequent viewing. The matching rules bedefined using simple or complex search expressions such “AND” or “OR.”Complex filter criteria may be stored on the image server 180 and thenused by local devices that access these records via the web.

Next, at a step 204, display rules are provided with respect to themedical images. In one embodiment, the display rules may be user-definedallowing the user to determine the timing, positioning, and size ofdisplayed matched images. For example, a user can define that matchedmedical images are all displayed concurrently on a display. Also, forexample, a user can define that the most recent of the matched medicalimages are displayed on the left hand portion of the display and theother matched medical images are displayed in sequence on the right handside of the display, the sequence advancing in response to userprompting. In one embodiment, the display rules include directives(timing, positioning, and size). As an example, directives can includethe following for identifying location information: TOP_DISPLAY,BOTTOM_DISPLAY, RIGHT_DISPLAY, LEFT_DISPLAY, CENTER DISPLAY.Furthermore, if the number of matched medical images is variable, thedisplay rules can include instructions for identifying selected medicalimages based upon further rules, such as using the matching criterialisted above. In addition, the display rules may or may not define howmany images or image series are displayed per monitor, a display grid(2×3, 5×4, etc.), or whether like images are displayed neighboring eachother side by side horizontally or vertically. Furthermore, the displayrules may also specify how different matched medical images fromdifferent series may be “interleaved” together for successive display.Using the computing system 100, a user may also manually interleavematched medical images, e.g., order the matched medical images forprogressive display of each of the matched sets. The computing system100 may also provide an interface to re-order images or image series tofacilitate the matching display, and may even reorient images (flip,rotate) in order to best match the display. Using the display rules, theuser can provide display rules such that related medical images arereadily comparable.

In one embodiment, display rules may be set to display pre and postcontrast axial T1 weighted images from a brain MRI from the same exam inadjacent panes on a monitor. Display rules may also be set to displayaxial T2 weighted MRI images from a prior spine MRI adjacent to axial T2weighted images from the current exam. Display rules may also be set todisplay a PA projection from a chest radiograph from a prior examadjacent to the same projection from the current exam.

Continuing to a step 206, naming rules are provided. The naming rulesdescribe how the medical images can be provided a new “name”, label, oridentifying description. In one embodiment, the naming rules are definedfor a particular individual or machine. In another embodiment, thematching rules are defined for a group or class of individuals. Therules may be provided by the users themselves and/or by a systemadministrator. The naming rules can define sets of naming rules fordifferent exam types or other classifications. The naming rules can alsobe defined to perform naming before or after the matching step 216. Inone embodiment, the naming rules define how information in a headerfile, e.g., DICOM file, that is associated with the medical image isdescribed. The naming rules can define that the new name of the medicalimage is defined using meta or other data that is associated with themedical images. It is noted that the new name of the medical image neednot be stored with the image but such information can be stored by anydevice connected to the network.

Continuing to a step 208, in one embodiment, the medical images arereceived by the computing system 100. It is noted that in oneembodiment, the medical images need not be stored locally by thecomputer system 100 but are merely made accessible to it via the networkContinuing to a step 212, the computing system 100 may optionally namethe received medical images based upon the received user-specific namingrules. In one embodiment, the new “names” of the medical images may beused by the computing system 100 to facilitate matching (step 216) ofrelated medical images. In one embodiment, the naming rules define howinformation in a header file, e.g., a DICOM file, is described. Thenaming rules can define that the “new” name of the medical image isdefined using meta or other data that is associated with the medicalimage. For example, the naming rules can define that the new “name” ofthe medical image is based upon the name of patient, the exam type, andthe date of the medical image. Also for example, the naming rules candefine categorization tables that define a particular name when certainconditions are met. The particular name can be predefined and/or basedupon meta or other data that is associated with the medical images.

Proceeding to a step 216, the computing system 100 matches medicalimages in the same or related series together as discussed above (step200). The matched images may be collectively or individually provided anew name per the naming rules provided in step 206. Continuing to a step220, the matched medical images are displayed. It is noted that thedisplay rules may define user display preferences that are specific forparticular types of medical images, e.g., the imaging modality, the bodypart, whether there is one exam, two, or more medical images beingdisplayed. The display rules may be defined per individual user, site,or system. In one embodiment, the user can store the display rules in adatabase. In one embodiment, one set of display rules can apply to onemodality and another set of display rules can apply to another modality.In addition, the display rules may include specific triggers or warningsthat occur if the user-defined display rules are not satisfied.

The foregoing description details certain embodiments of the invention.It will be appreciated, however, that no matter how detailed theforegoing appears in text, the invention can be practiced in many ways.As is also stated above, it should be noted that the use of particularterminology when describing certain features or aspects of the inventionshould not be taken to imply that the terminology is being re-definedherein to be restricted to including any specific characteristics of thefeatures or aspects of the invention with which that terminology isassociated. The scope of the invention should therefore be construed inaccordance with the appended claims and any equivalents thereof.

What is claimed is:
 1. A computing system comprising: one or morehardware computer processors; and one or more software modulesconfigured for execution by the one or more computer processors to causethe computing system to: in response to user input, automatically:select a first image series and a second image series each associatedwith a particular patient and including images of a particular modality;determine an order for display of images of the first image series andthe second image series, wherein the order is based on anatomicalpositions of the patient depicted in respective images; and displayimages of the first image series and the second image series, one at atime in a single image pane, in the determined order.
 2. The computingsystem of claim 1, wherein the order is further based on one or more ofdate or time of acquisition of respective displayed images, lateralityof images, or view of images.
 3. The computing system of claim 1,wherein the user input is received from an input device in communicationwith the computing system.
 4. The computing system of claim 1, whereinthe one or more software modules are further configured to cause thecomputing system to: select images of the first image series and thesecond image series each associated with a different particularmodality; determine a second order for display of the selected images ofthe first image series and the second image series, wherein the secondorder is based on anatomical positions of the patient depicted inrespective selected images; and display the selected images of the firstimage series and the second image series, one at a time in a singlesecond image pane, in the determined second order.
 5. The computingsystem of claim 1, further comprising: registering, by the computingsystem, images of different image series that are displayed in thesingle image pane.
 6. The computing system of claim 5, wherein saidregistering is based on one or more of aligning centers of images in thedifferent image series or linking scrolling between images displayed indifferent image panes.
 7. A computing system comprising: one or morehardware computer processors; and one or more software modulesconfigured for execution by the one or more computer processors to causethe computing system to: in response to user input, automatically:select a first image series and a second image series each associatedwith a particular patient and including images of a particular modality,wherein the first image series and the second image series togethercomprise a matched set; determine an order for display of images of thematched set, wherein the images of the first image series and a secondimage series are ordered for progressive display of the matched set; anddisplay images of the matched set, one at a time in a single image pane,in the determined order.
 8. The computing system of claim 7, wherein theorder is based on one or more of date or time of acquisition ofrespective displayed images, laterality of images, or view of images. 9.The computing system of claim 7, wherein the user input is received froman input device in communication with the computing system.
 10. Thecomputing system of claim 7, wherein the one or more software modulesare further configured to cause the computing system to: select imagesof the first image series and the second image series each associatedwith a different particular modality, wherein the selected images of thefirst image series and the second image series together comprise asecond matched set; determine a second order for display of the selectedimages of the second matched set, wherein the selected images of thefirst image series and the second image series are ordered forprogressive display of the second matched set; and display the selectedimages of the second matched set, one at a time in a single second imagepane, in the determined second order.